What should you know about large diastasis recti?

Diastasis recti, also called abdominal separation, occurs when the connective tissue between the two long abdominal muscles stretches and the muscles sit farther apart. It commonly becomes noticeable during or after pregnancy, but changes in abdominal pressure and muscle loading can have other causes. You may see a ridge or doming along the middle of the abdomen when sitting up, coughing or lifting. Back discomfort, reduced trunk control or a feeling of weakness can also occur.

The visible gap does not tell the whole story. Strength, coordination, pain and everyday function matter when deciding whether support is needed.

A pelvic-health or postnatal physiotherapist can assess your abdominal wall, breathing, posture and movement patterns. They can teach gradual exercises that coordinate the deep abdominal muscles with the pelvic floor and breathing. Postnatal physiotherapy may be useful after birth or when symptoms affect lifting, exercise or daily activities. Progress should be steady and comfortable rather than driven by forceful sit-ups or breath-holding.

Use a slow exhale during effort, avoid straining, and modify any activity that causes pain or pronounced doming. Ask for an individual plan if you have had a caesarean birth, abdominal surgery or a hernia.

Seek prompt medical advice for a painful or firm abdominal bulge, vomiting, inability to pass stool or gas, fever, sudden severe pain, or a bulge that cannot be eased. These features may point to a separate abdominal problem rather than diastasis alone. Arrange assessment for persistent pain or worsening function.

Ask whether the finding is diastasis or a hernia, which activities to modify, how progress will be measured, and whether physiotherapy should be tailored to your birth or surgery history.